The Impact of Hospital-Acquired Infection on Outcome in Acute Pancreatitis

Wu, Bechien U.; Johannes, Richard S.; Kurtz, Stephen G.; Banks, Peter A.

doi:10.1053/j.gastro.2008.05.053

Cited by 60 publications

(54 citation statements)

References 28 publications

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“…The presence of extra-pancreatic infection was a risk factor for infected necrosis, and in 61% of cases with pancreatic infection, the same pathologic organism was isolated from pancreatic and extra-pancreatic tissue. In a separate study of 11,046 cases of acute pancreatitis from US hospitals, 15% of all fatal cases of acute pancreatitis were associated with hospital-acquired infection [20]. Extra-pancreatic infection was associated with a significantly increased mortality even after adjusting for disease severity.…”

Section: Infectionmentioning

confidence: 95%

Update in Acute Pancreatitis

Conwell

2010

Curr Gastroenterol Rep

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Acute pancreatitis is a common cause for hospitalization that carries a substantial burden of disease in the United States and worldwide. Recent reports have encompassed a wide array of topics including new insights into the acinar cell pH microenvironment, signal pathways for acinar cell fate, and the innate immune response. Clinical researchers have reported new methods to assess disease severity, innovative techniques for management of local complications, the importance of early recognition of pancreatic or extrapancreatic infection, and prevention of disease recurrence. Recent data also suggest that specialized centers may be of benefit for the management of severe acute pancreatitis. This review summarizes a number of recent advances in basic and clinical science with an emphasis on findings that are relevant to clinicians who manage patients with acute pancreatitis.

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Section: Infectionmentioning

confidence: 95%

Update in Acute Pancreatitis

Conwell

2010

Curr Gastroenterol Rep

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“…As in other diseases, hospital-acquired infection leads to elevated costs. Wu and coworkers [2] reviewed more than 11,000 patients with acute pancreatitis and found that 0.7% developed a hospital-acquired (nosocomial) infection, which was associated with a 9-fold to 10-fold increase in mortality and a signifi cant increase in total costs.…”

Section: Introductionmentioning

confidence: 99%

The changing character of acute pancreatitis: Epidemiology, etiology, and prognosis

Lowenfels

Maisonneuve²,

Sullivan³

2009

Curr Gastroenterol Rep

187

109

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Acute pancreatitis continues to be a diagnostic and therapeutic challenge for physicians and surgeons. It ranks third in the list of hospital discharges for gastro-intestinal diseases. In most patients the cause is either gallstones or alcoholism. The overall mortality is less than 5%, but severe acute pancreatitis leads to prolonged hospitalization and much higher mortality. There are important differences in disease susceptibility and case fatality rates: the incidence is higher in blacks than in whites, and mortality is higher in older patients than in younger patients. Reports from various countries reveal that the frequency of acute pancreatitis is increasing, perhaps in relation to rising obesity rates, which would increase the likelihood of gallstone pancreatitis. Conversely, mortality rates for acute pancreatitis are declining in many, but not all, reports.

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“…Their infection tends to occur in 10-70% of cases with pancreatic necrosis and increases mortality (23). The distinction between sterile or infected collections is very important because they have different prognosis and treatment (24).…”

Section: Discussionmentioning

confidence: 99%

Severe Acute Pancreatitis - Determinant Factors and Current Therapeutic Conduct

Constantinoiu¹,

Cochior²

2018

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RezumatAşa cum a fost considerată de Dieulafoy şi cum a rămas, pe drept cuvânt "marea drama abdominală", pancreatita acută a constituit întotdeauna, rămânând ca atare şi în prezent, o adevărată provocare diagnostică şi terapeutică din cauza variabilităţii sale etiologice, clinice şi biologice, caracterului imprevizibil al evoluţiei şi dificultăţilor de stabilire a tratamentului adecvat fiecărui pacient. În acest context s-au confruntat de-a lungul timpului concepţii diferite, uneori diametral opuse, cu privire la interpretarea cazurilor şi la algoritmul terapeutic adoptat, dovadă stând numărul foarte mare de lucrări consacrate acestui subiect. Înţelegerea mai aprofundată a fiziopatologiei pancreatitei acute odată cu creşterea interesului în clasificarea severităţii pe baza factorilor determinanţi (locali şi generali) reprezintă factori decisivi în preconizarea severităţii şi adoptarea strategiei terapeutice moderne a acestei maladii complexe şi heterogene.Cuvinte cheie: pancreatita acută severă, factori determinanţi, disfuncţie multiplă de organe (MODS), necroză închistată (WONwalled of necrosis), necrozectomie, tehnici chirurgicale hibride Abstract Considered by Dieulafoy as the "great abdominal drama", acute pancreatitis has always been, and still remains, a real diagnostic and therapeutic challenge because of its etiological, clinical and biological variability, the unpredictable evolution and the difficulty of establishing appropriate treatment for each patient. In this context, various, sometimes diametrically opposed, conceptions about the interpretation of the cases and the adopted therapeutic algorithm have been encountered over time, as evidenced by the great number of papers dedicated to this subject. A more thorough understanding of acute pancreatitis pathophysiology, with increasing interest in severity classification based on determinant factors (local and general) are decisive factors in predicting severity and adopting the modern therapeutic strategy of this complex and heterogeneous disease.

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The Impact of Hospital-Acquired Infection on Outcome in Acute Pancreatitis

Abstract: We determined that HAI had a major impact on mortality in AP. Patients who developed HAI also had significantly increased LOS and hospital charges. These differences were not explained by increased disease severity alone. Reducing HAI is an important step to improving outcome in AP.

Cited by 60 publications

References 28 publications

Update in Acute Pancreatitis

Update in Acute Pancreatitis

The changing character of acute pancreatitis: Epidemiology, etiology, and prognosis

Severe Acute Pancreatitis - Determinant Factors and Current Therapeutic Conduct

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